PRESBYOND may be considered in early, well‑controlled glaucoma, but advanced or unstable disease often makes it unsuitable.
Issues specific to glaucoma
Monitoring and safety are more complex.
- Post‑laser changes in corneal thickness affect intraocular‑pressure readings
- Existing visual‑field loss and contrast reduction may limit benefit
- Multifocal optics could further reduce contrast in compromised optic nerves
- Advanced glaucoma increases the risk of disappointing outcomes
- Some glaucoma medications worsen dry eye, affecting laser suitability
When it may still be appropriate
Requires close collaboration with a glaucoma specialist.
- Stable, early glaucoma with preserved fields and structural stability
- Open angles and well‑controlled pressure
- Careful consideration of risks versus presbyopic benefits
- Agreement on long‑term follow‑up and pressure monitoring after surgery
- Priority always remains on protecting optic‑nerve health
